The House and the Senate have their first moves toward dismantling Obamacare—and much of the nation's healthcare system—including a Senate vote Wednesday moving forward on the budget resolution. So Obamacare repeal using the complicated budget reconciliation process has officially begun.
Not long after Donald Trump was elected president, GOP lawmakers made clear their intent to use reconciliation to repeal Obamacare, following the model of 2015 legislation that was vetoed by President Obama last year. Though some Republicans have expressed reservations about going forward with repeal without a replacement plan ready, Tuesday’s introduction of the budget resolution suggests lawmakers are willing to charge forward nonetheless. The resolution is not meant to become law, and thus won’t need a president’s signature. In this case it merely exists as a vehicle directing the committees relevant to an ACA repeal to begin working on the reconciliation bill.
“All this does is it triggers the start of a process where Congress would have agreed to a reconciliation directive,” said Richard Kogan, a former senior adviser at the Office of Management and Budget before joining the Center on Budget and Policy Priorities.
Once the resolution is approved by a majority vote in both chambers, committees in the House (Energy and Commerce; and Ways and Means) and in the Senate (Finance; and Health, Education, Labor, and Pensions) will start working on the actual repeal legislation which will spell out just what parts of Obamacare Republicans will dismantle. The resolution gives the committees until Jan. 27 to submit their proposals, but that deadline is somewhat arbitrary.
Never mind that they have no idea at all where they’re going with this, they’re revving up the engine. It’s a really complicated engine, too, and here's a good primer from The New York Times on how budget reconciliation works, and all the steps that Republicans will have to go through to make it happen. It's in that complicated process that Democrats have their chance to make it as painful as possible for Republicans to accomplish, as Ed Kilgore reminds us.
Individual votes to preserve preexisting condition requirements for insurers on every single illness that could count as a preexisting condition? That could happen, as could votes on Democratic amendments highlighting everything this law does that's popular. The "vote-a-rama" will start in the next several days, and that's where Democrats can fight back and make the handful of Republicans for whom reality is sinking in feel the pain, and maybe, just maybe do the right thing.
Democrats have absolutely nothing to lose by making this process a living hell for Republicans, for making them own it, as President Obama has told them. Make this hurt.